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益生菌预防结直肠癌患者术后感染:一项系统评价和荟萃分析。

Probiotics for preventing postoperative infection in colorectal cancer patients: a systematic review and meta-analysis.

作者信息

Ouyang Xiaojing, Li Qingfeng, Shi Mengjing, Niu Dongsheng, Song Wenjing, Nian Qinggong, Li Xiangda, Ding Zhonghui, Ai Xianyin, Wang Jian

机构信息

Department of Gastroenterology, The Third Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.

Center for Disease Prevention and Control of Beijing Military Region, Beijing, 100042, China.

出版信息

Int J Colorectal Dis. 2019 Mar;34(3):459-469. doi: 10.1007/s00384-018-3214-4. Epub 2018 Dec 11.

Abstract

PURPOSE

Postoperative infection has seriously affected the prognosis of cancer patients, while probiotics have been increasingly used to prevent postoperative infection in clinical practice. This study aimed to evaluate the preventive effect of probiotics on infection after colorectal cancer (CRC) surgery.

METHODS

Related clinical trial reports were collected from Pubmed, Embase, Cochrane Library as well as China National Knowledge Infrastructure (CNKI) databases. These reports were then strictly screened, and information as well as data were extracted. Finally, the enrolled studies were evaluated by systematic review and meta-analysis using STATA v11 and Revman v5.2.

RESULTS

Probiotics administration contributed to the reduction of overall infection rate after colorectal surgery, with a pooled odds ratio (OR) of 0.51 (95% CI: 0.38-0.68, P = 0.00). Meanwhile, the incidence of incision infection (pooled OR = 0.59, 95% CI 0.39-0.88, P = 0.01) and pneumonia (pooled OR = 0.56, 95% CI 0.32-0.98, P = 0.04) as well as the first flatus time (SMDs = - 0.70, 95% CI - 1.13-- 0.27, P = 0.002) were also reduced by probiotics. In addition, urinary tract infection, anastomotic leakage, and duration of postoperative pyrexia were also analyzed, which displayed no statistical differences compared with those of control.

CONCLUSION

Probiotics have potential efficacy on preventing postoperative infection and related complications in cancer patients undergoing colorectal surgery.

摘要

目的

术后感染严重影响癌症患者的预后,而益生菌在临床实践中越来越多地用于预防术后感染。本研究旨在评估益生菌对结直肠癌(CRC)手术后感染的预防作用。

方法

从PubMed、Embase、Cochrane图书馆以及中国知网(CNKI)数据库收集相关临床试验报告。然后对这些报告进行严格筛选,提取信息和数据。最后,使用STATA v11和Revman v5.2通过系统评价和荟萃分析对纳入的研究进行评估。

结果

服用益生菌有助于降低结直肠手术后的总体感染率,合并比值比(OR)为0.51(95%CI:0.38 - 0.68,P = 0.00)。同时,益生菌还降低了切口感染发生率(合并OR = 0.59,95%CI 0.39 - 0.88,P = 0.01)、肺炎发生率(合并OR = 0.56,95%CI 0.32 - 0.98,P = 0.04)以及首次排气时间(标准化均数差 = - 0.70,95%CI - 1.13 - - 0.27,P = 0.002)。此外,还分析了尿路感染、吻合口漏和术后发热持续时间,与对照组相比无统计学差异。

结论

益生菌对接受结直肠手术的癌症患者预防术后感染及相关并发症具有潜在疗效。

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